| NPI | 1578778858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY11884) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: HI PSY-1725) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY11884) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: HI PSY-1725) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY11884) | |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2023-07-19 |